Harper government scuttles Health Council of Canada

The Conservative government has informed the Health Council of Canada that its funding will be discontinued with next year’s expiry of the intergovernmental health accords.

The independent national agency has served as the primary accountability mechanism for the 2003 First Ministers’ Accord on Health Care Renewal and the 2004 10-Year Plan to Strengthen Health Care, reporting annually to Canadians about the quality, effectiveness and sustainability of the health care system.

The council was told last week that with next year’s expiry of the intergovernmental health agreements, “there is no longer a need” for it to monitor progress on health care renewal and reform in Canada.

Health Council CEO John Abbott says Health Canada told the agency’s board that the federal fiscal situation and the expiry of the accords justified discontinuation of its funding.

Abbott added that he was “disappointed” by the decision because the council, along with many health experts, “see a continuing role for the council around, really two things: the accountability side, as well as raising Canadians understanding of the health care system, the issues at play.”

Abbott said several councillors indicated that axing the council is consistent with the federal government’s decision to vacate the health field. “This would be seen as a logical extension of that, so in that sense, it wouldn’t come as a surprise. But collectively, they were disappointed and felt that this was probably not the right decision and that this council, or a facsimile thereof, is definitely needed in the Canadian context.”

Abbott added that he didn’t believe the hard-hitting nature of the council’s reports prompted the funding cut. “I feel comfortable that that would not be the factor that drove this decision.”

Several council officials reacted with incredulity to Harper’s move.

“We’re stunned,” said one official. “It’s not like health care is no longer an issue.”

“Harper is basically thumbing his nose at the provinces,” added a provincial official. “There can’t be a bigger signal that Ottawa is walking away from the health file.”

Asked what he thought would be the primary consequence of the federal government’s decision to vacate the health field, Abbott said he fears there’ll be a continuing and ongoing diminution in equal access to health care for Canadians.

The Canada Health Act exists to ensure equity and “that situation will not change in the forseeable future,” he said. “To help enforce their role, they need to be able to report out objectively that they’re meeting that. That was the reason why we were set up. Nothing has changed and, I would argue, that’s the reason why we should continue.”

“That’s the piece that will be missing because the provinces are in it for themselves. I don’t mean that in a negative sense but the premier of Ontario speaks for the people of Ontario,” not for all of Canada, he added. “Health ministers don’t operate in a collective sense in their decision-making, so having the federal government at the table helps. When they make decisions, they make them for all Canadians. That’s the part that slowly but surely is being diminished.”

Asked if there was any hope that the provinces might step in with funding to save the council, Abbott said “we’re not optimistic on that front.” The provinces are also in a fiscal bind “but we’ll have conversations with anyone” about the possibility.

Created in 2004, the Council typically received between $8 million to $10 million from the federal government each year but always underspent its budget and returned between $2.5 million to $3 million annually to federal coffers. It spent $5.64 million in fiscal 2011/12 for its operations, according to its latest annual corporate report.

Headed by 12 councillors (and one ex-officio councillor) appointed by participating provincial and territorial governments and the government of Canada, the Council is unique in that it is a rare example of intergovernmental co-operation on the thorny and often-dysfunctional health file.

Chaired by Dr. Jack Kitts, President and CEO of The Ottawa Hospital, the council’s progress reports, including one in 2012 that lamented the lack of “clear parameters for change, or the type of reporting that would be useful to the jurisdictions to measure such change,” have long been must-reads for the nation’s health community.

The council was mandated, as well, to disseminate information on “leading practices and innovation” in the health system, and to that end, it has also produced such reports as one in March on quality improvement.

The council plans to complete and release its 2013 progress report in May, while also finishing a “summative” report on the health accords this fall, as well as complete an investigation into the health of Aboriginal seniors, before shutting the doors of its Toronto office next year.

The notion of some manner of Health Council of Canada was first urged in Building on Values, the final report of the Romanow Commission on the Future of Health Care in Canada, primarily as a vehicle to resolve intergovernmental health disputes.

Although its final structure was nowhere near that ambitious, and the province of Alberta for years refused to participate on the grounds that the council was a “federal watchdog agency,” it has often provided a clear window into the performance of the health system and its many variations from province to province. Quebec never agreed to participate in the council.